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Home My WebLink AboutBLDE-22-005402 #42 /1 Commonwealth of official Use Only E. ,I Massachusetts Permit No. BLDE-22-005402 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:3/28/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 42 GE11 WILFIN RD Owner or Tenant MESSURI MARY Telephone No. - Owner's Address 34 COOLIDGE RD,WINCHESTER, MA 01890-2251 �,'� ,� Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr,A iafe.Bq .,., Purpose of Building Utility Authorization No. ° ti Existing Service Amps Volts Overhead 0 Undgrd 0 No.'' 11 re s'\ ' New Service Amps Volts Overhead ❑ Undgrd 0 No.of tie L `v''r) Number of Feeders and Ampacity '.. "/� Location and Nature of Proposed Electrical Work: Install 2-20 amp circuits / ' E>`', Completion of the following table may be w v'' ., e .•cto tres. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of fe) )occ';> i tt Transformers No.of Luminaire Outlets No.of Hot Tubs Generators 2 4414 No.of Luminaires Swimming Pool Ab ❑ In- ❑ No.of Emergency Lighting grnove d. grnd. Battery Units No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: PAUL J VIOLETTE Licensee: Paul J Violette Signature LIC.NO.: 20858 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 18 ANCHOR DR, FORESTDALE MA 026441822 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. ��5 PERMIT FEE: $50.00 (U (Z r L �G-v15s‘ (i/n) 1 /7vr�� 634-4"' /4 V' r> ----- • ta i Tecz o!'pf eras fir• fficid Use�Only`^-7 G"`: ttCL14 ,;F:� 1FffEFua r::lSc. �"1'O Z— it =1 Permit No. Department of Fire Services _ Occupancy and Pet Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank) w��l APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK i al2 All work to be performed in accordance with the Massachusetts Electrical Code /527 C21R 12.00 —I v a' 'LEASE PRINT IN INK Operformed 'ALLINFORMATIOIJ) Date: 3 d 4'4 LLI ° C' or Town of: "I cr f`rst a 6 :Ft c� City �h To the Inspect r of Wires: O Z :,this application the undersigned gives notice of his or her invention to perform the electrical work described below. W, o I It.cation(Street&Number) I'l oZ L.)t I n R s) ce m,r- ,er or Tenant J d -e- I� I, Telephone No. a wuer's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building 1 F/- r"1 Utility Au orization No. Existing Service Amps / Volts Overhead Undgrd] No.of Meters New Service Amps / Volts Overhead Undgrd'! No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ,,s dy/) tZ Oil- C i r•c'<.'4 f -ci s 4-c c.1L to As]-, / Qr5.-e_c Completion of the fo/lowingtta1 T KVAble may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceii.-Susp.(Paddle)Fans r•of Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimming Pal Above In- No.or Emergency Lighnng grad. �grnd. II Battery Units No.of Receptacle Outlets a, a No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Toms No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number. Tons IKW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Trouu nicipalectio n e-I I �-- i GL No.of Dryers Heating Appliances Kqt Security Systems:' p No.of Devices or Equivalent ‘.3...., No.of Water KW No.of No.of Data Wiring: --- Heaters signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP 'Telecommunications Wiring: No.of Devices or Equivalent • OTHER: Attach additional decall if desired.or as required by the Inspector of Wirer. Estimated Value of Electrical Work: (When required by municipal policy.) ® Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including`completed operation"coverage or its substantial equivalent. The undersigned certifies that such covers in force,and has exhibited proof of same to the permit issuing office. y CHECK ONE: INSURANCE BOND❑OTHER S ecify V, � P 1 �. I cartify,under the pains and Pies of p � that the rn armatwn on this application is true and complete. 'O FIRM NAME: V i o 1 t E)Gc.-r,c L L C-,, LIC.NO.:Ac,1 f} Licensee: P.,I S. V i‘o to j.Ie.-- Signature Pcc.,..26)c)�c�— LIC.NO.:c)oBS ',4 � (if applicable,enter"exempt..in the ' line.) U Bus:Tel.No.: J S Address: ' q,.,,{,,,,/- r �,-Q 'For-el+O4 Le- part_ t o a4y Alt.TeL No.:50e-.36Y-5.595 S 'Security System Contractor License required for this work;if applicable,enter the license bomber here: cy. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability i ce co a normally required by law. By my signature below,I hereby waive this requirement. 1 ant the(check one) \met's agent. Owne:-!Agent l _ Signature Telephone No. PERMIT FEE:$ w _ y..e,